Narváez J, Clavaguera M T, Nolla-Solé J M, Valverde-Garcia J, Roig-Escofet D
Department of Rheumatology, Hospital Príncipes de España, Ciudad Sanitaria y Universitaria de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.
J Rheumatol. 2000 Apr;27(4):953-7.
The etiology of giant cell arteritis (GCA) is unknown, but its sudden onset and the wide variation in incidence reported from various parts of the world suggest a genetic predisposition and/or the influence of environmental factors, such as infectious agents or a seasonal effect. We analyzed the influence of season on GCA in our area over the period 1985-97, as well as the possible association between infection and onset.
Retrospective study of 143 cases of GCA diagnosed from 1985 to 1997. To evaluate seasonal variation in disease onset, the month of onset of the first symptoms related to GCA was used to calculate season-specific incidence rates. Differences between season incidence rates were assessed by chi-square test. To test for an association between infection and GCA onset, we considered only infections that occurred within 2 months before the onset of disease. Because of the difficulty in determining whether an infection was present using only the clinical and laboratory data recorded in patients' medical charts, we categorized the likelihood of patients having infection into 3 groups: no infection, probable infection, and definite infection.
Between 1985 and 1997 (both years included), a total of 143 patients (88 women, 55 men) were diagnosed with GCA. Of these, 85 had isolated polymyalgia rheumatica (PMR), 22 had temporal arteritis (TA) without PMR, and 36 had PMR associated with TA. The main clinical features in our population were similar to those reported in other studies. We found no seasonal variation in disease onset during the 13 year period. Moreover, only one (0.7%) of 143 patients was categorized as a probable infection, whereas definite infection was not observed in any case. From these results, the hypothesis of an infectious cause for GCA seems highly improbable.
We were unable to observe a seasonal pattern or an association between infection and the onset of GCA.
巨细胞动脉炎（GCA）的病因尚不清楚，但其起病突然，且世界各地报道的发病率差异很大，这表明存在遗传易感性和/或环境因素的影响，如感染因子或季节效应。我们分析了1985 - 1997年期间季节对我们地区GCA的影响，以及感染与发病之间可能存在的关联。
对1985年至1997年诊断的143例GCA病例进行回顾性研究。为评估疾病发病的季节性变化，使用与GCA相关的首个症状出现的月份来计算特定季节的发病率。通过卡方检验评估季节发病率之间的差异。为检验感染与GCA发病之间的关联，我们仅考虑在疾病发病前2个月内发生的感染。由于仅使用患者病历中记录的临床和实验室数据难以确定是否存在感染，我们将患者发生感染的可能性分为3组：无感染、可能感染和确诊感染。
在1985年至1997年（包括这两年）期间，共有143例患者（88名女性，55名男性）被诊断为GCA。其中，85例患有单纯性风湿性多肌痛（PMR），22例患有无PMR的颞动脉炎（TA），36例患有与TA相关的PMR。我们研究人群的主要临床特征与其他研究报道的相似。我们发现在这13年期间疾病发病无季节性变化。此外，143例患者中只有1例（0.7%）被归类为可能感染，而在任何病例中均未观察到确诊感染。基于这些结果，GCA由感染引起的假说似乎极不可能。
我们未能观察到GCA发病的季节性模式或感染与发病之间的关联。
